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The Future of Healthcare Naviquis

HEALTHCARE PAYMENT INTEGRITY SOLUTION 

Detection | Prevention | Transparency | Communication

WHERE INNOVATION MEETS CREATIVITY

Combining the Power of AI + ML + MCBK

AI

ARTIFICIAL INTELLIGENCE
(AI)

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MACHINE LEARNING
(ML)

Naviquis utilizes a combination of algorithms, expert systems, computable biomedical knowledge, artificial intelligence (AI), and machine learning (ML) to offer an almost real-time solution for automated detection and prevention of healthcare fraud, waste, and abuse (FWA).

Our secure solution identifies suspicious claims before payment, providing communication, alerts, credentialing support, and educational notes to providers through the Naviquis Provider Relationship Management System (PRMS). This proactive strategy not only enhances payment integrity but significantly increases client savings and reduces provider abrasion and administrative costs.

Doctor on Computer

Designed to Reduce Abrasion & Improve Relations With Your Network

The PRMS encompasses a suite of advanced functionalities, including:

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Communication Platform:
Ensures secure, fully automated, real-time communication with providers, streamlining the exchange of crucial information.

 

Provider Engagement:
Minimizes the risk of provider abrasion, optimizing the efficiency of FWA programs by maintaining transparent and effective communication channels.

 

Education Hub:

Delivers a wealth of educational materials to providers, fostering awareness of FWA, prevention strategies, and best practices. This initiative promotes a culture of compliance and shared responsibility within the healthcare network.

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Monitoring Support:
Offers assistance for credentialing and licensing through proactive monitoring, identifying and addressing potential issues before they escalate.

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AVOID IMPROPER PAYMENTS

Business Intelligence

Precision Edits

Reporting Analysis

Communication

Payment Integrity Vendor Solution

Identify Suspicious Claims BEFORE They Impact Your Bottom Line

An estimated $68 billion of the $4.5 trillion spent on medical care nationwide is lost to medical fraud, waste, and abuse (FWA) every year.

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Fight back with our innovative Fraud Detection Software!

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Our post-adjudication, pre-pay integrity solution detects and prevents most common errors and fraudulent activities. This comprehensive solution reduces overall costs and provides an immediate ROI while increasing client savings, TPA revenues, and provider satisfaction.

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2012

Year

Established

5%

Average Savings Found by Naviquis

10 to 1

ROI

Utilizing Naviquis

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